Department of Infectious Diseases and Clinical Microbiology, Istanbul Gaziosmanpasa Training and Research Hospital, University of Health Sciences, Istanbul, Turkey.
Department of Chest Diseases, Istanbul Yedikule Chest Diseases and Chest Surgery Training and Research Hospital, Istanbul, Turkey.
J Med Virol. 2022 Jan;94(1):291-297. doi: 10.1002/jmv.27319. Epub 2021 Sep 15.
Due to current advances and growing experience in the management of coronavirus Disease 2019 (COVID-19), the outcome of COVID-19 patients with severe/critical illness would be expected to be better in the second wave compared with the first wave. As our hospitalization criteria changed in the second wave, we aimed to investigate whether a favorable outcome occurred in hospitalized COVID-19 patients with only severe/critical illness. Among 642 laboratory-confirmed hospitalized COVID-19 patients in the first wave and 1121 in the second wave, those who met World Health Organization (WHO) definitions for severe or critical illness on admission or during follow-up were surveyed. Data on demographics, comorbidities, C-reactive protein (CRP) levels on admission, and outcomes were obtained from an electronic hospital database. Univariate analysis was performed to compare the characteristics of patients in the first and second waves. There were 228 (35.5%) patients with severe/critical illness in the first wave and 681 (60.7%) in the second wave. Both groups were similar in terms of age, gender, and comorbidities, other than chronic kidney disease. Median serum CRP levels were significantly higher in patients in the second wave compared with those in the first wave [109 mg/L (interquartile range [IQR]: 65-157) vs. 87 mg/L (IQR: 39-140); p < 0.001]. However, intensive care unit admission and mortality rates were similar among the waves. Even though a lower mortality rate in the second wave has been reported in previous studies, including all hospitalized COVID-19 patients, we found similar demographics and outcomes among hospitalized COVID-19 patients with severe/critical illness in the first and second wave.
由于目前在 2019 冠状病毒病（COVID-19）管理方面的进展和经验的不断积累，与第一波相比，第二波中 COVID-19 重症/危重症患者的结局预计会更好。由于我们在第二波中的住院标准发生了变化，我们旨在研究仅患有重症/危重症的住院 COVID-19 患者是否会出现良好的结局。在第一波中，有 642 例经实验室确诊的住院 COVID-19 患者，在第二波中，有 1121 例，他们在入院或随访期间符合世界卫生组织（WHO）关于重症或危重症的定义。从电子医院数据库中获取了人口统计学、合并症、入院时 C 反应蛋白（CRP）水平和结局的数据。采用单变量分析比较了第一波和第二波患者的特征。第一波中有 228 例（35.5%）患者患有重症/危重症，第二波中有 681 例（60.7%）。除慢性肾脏病外，两组在年龄、性别和合并症方面相似。与第一波相比，第二波中患者的中位血清 CRP 水平显著更高[109mg/L（四分位距[IQR]：65-157）vs. 87mg/L（IQR：39-140）；p<0.001]。然而，两波之间的重症监护病房入住率和死亡率相似。尽管之前的研究报告第二波的死亡率较低，包括所有住院 COVID-19 患者，但我们发现第一波和第二波中患有重症/危重症的住院 COVID-19 患者的人口统计学和结局相似。
